Prenatal diagnosis for women aged 37 years and over: to have or not to have

Forty percent of pregnant women aged 37 years and over do not have prenatal diagnosis despite being eligible for a free test. The present study aimed to determine how often, and which, untested women were making a choice about this, how many declined an offer and why. A questionnaire was given to untested women, aged 37 years and over, at no less than 24 weeks gestation. A total of 375 (81.5%) women declined, 72 (16%) were not offered a test and 13 presented too late antenatally. There was a three-fold increased likelihood (OR 3.10 95% CI 1.44, 6.65) of no offer for urban non-English speaking background women, compared with the reference group (metropolitan, English speaking). Unpartnered women were also significantly less likely to receive an offer (OR 3.18, 95% CI 1.19, 8.46). Risk to the baby was the main reason for declining. When offered non-invasive prenatal screening, most decliners of prenatal diagnosis accepted, even those who declined because they were opposed to abortion. We estimate that overall 33% of older pregnant women were being offered and declining amniocentesis and/or chorion villus sampling (CVS). Only 6% were not offered a test, but this small proportion is over-represented by minority groups who must be given equal opportunity to make this choice. Copyright © 2001 John Wiley & Sons, Ltd.     

Inaccurate estimation of risk in second trimester serum screening for Down syndrome among women who have already had first trimester screening

Problems can arise in prenatal screening for Down syndrome when tests are performed in the first and second trimester and some women who have a negative first trimester test have a second trimester serum test. The second test result does not usually take account of the previous one being negative. Even if it does, it is often inaccurate. Using published data the extent of the error was examined. The age-specific risk of an affected pregnancy in such women will be lower than if no first trimester test had been performed. The distributions of the screening markers in affected and unaffected pregnancies will be different from those in unscreened women. If the appropriate age-specific risk and marker distributions are not used, error will arise. For example, a 35-year-old woman with nuchal translucency (NT), pregnancy-associated plasma protein-A (PAPP-A) and free β-human chorionic gonadotrophin (hCG) levels at the normal median would have a risk of 1 in 6500. If she then had the Triple Test with alpha-fetoprotein (AFP), unconjugated oestriol, and hCG levels of 0.7, 0.7 and 1.5 multiples of the median (MoM), respectively, her risk, ignoring the previous result, would be overestimated (1 in 95 compared with the correct estimate of 1 in 705). If the previous result was included, but the age-specific risk and second trimester marker distributions were not revised, her risk would be underestimated (1 in 820). If the correct age-specific risk and screening marker distributions were used, risk estimates would be accurate, but two tests would be less efficient than integrating all the screening information into a single test. The practice of offering second trimester serum screening to women who have already been screened is best avoided. Copyright © 2001 John Wiley & Sons, Ltd.     

PAM在污泥脱水中的筛选研究

污泥的处理与处置是城镇生活污水处理系统中的重要组成部分.在机械脱水过程中,采用投加药剂提高污泥脱水效果,根据不同污泥组成,选择不同类型高分子聚丙烯酰胺.本文以某城市生活污水处理厂污泥为处理对象,考察污泥含水率、污泥沉降性能等指标,通过实验室小试,对8种聚丙烯酰胺(WS1-WS8)的溶解性能、粘度性能和脱水效果进行对比试验研究,优选出2种PAM及其配比浓度,以离心脱水一体机为脱水设备,进行上机应用试验,并通过对比泥饼含水率,确定最佳絮凝剂为WS7.     

我国地表水中药物与个人护理品污染现状及其繁殖毒性筛查

根据文献报道,我国地表水中已检出至少144种药物及个人护理用品(pharmaceuticals and personal care products,PPCPs),包括抗生素、激素、其他药物、个人护理品(personal care products,PCPs)4大类,其中检出浓度最高的达到了μg·L~(-1)量级,在长期的污染下有可能对水生生物产生内分泌干扰效应或繁殖毒性,进而影响到整个水生生物种群的繁衍变化。因此,有必要根据我国地表水中PPCPs的污染水平,筛查出具有潜在生态风险的PPCPs。由于目前缺乏针对PPCPs类污染物的筛选体系,以国内外优先控制污染物筛选体系为基础,借鉴基于风险的欧洲兽药分级方法,利用风险指数(risk index,RI),筛选得出目前我国的地表水中有16种具有繁殖毒性的PPCPs的RI1,包括1种抗生素,5种激素类药物,3种其他药物和7种PCPs,其中乙炔雌二醇(ethinylestradiol,EE2)的RI最高(115 730),其次是壬基酚(nonylphenol,NP)(1 796)、邻苯二甲酸二丁酯(dibutyl phthalate,DBP)(255.31),对水生态环境有较高的风险的PPCPs需进一步进行较高层次的风险评价。